orporation doing business in this State. 5. No person not certificated under this chapter shall use in its name, contracts or literature the phrase “health maintenance organization” or the initials “HMO.” (Added to NRS by 1973, 1253) NRS 695C.310 Examinations. 1. The Commissioner shall make an examination of the affairs of any health maintenance organization and providers with whom such organization has contracts, agreements or other arrangements pursuant to its health care plan as often as he deems it necessary for the protection of the interests of the people of this State. An examination must be made not less frequently than once every 3 years. 2. The State Board of Health shall make an examination concerning the quality of health care services of any health maintenance organization and providers with whom such organization has contracts, agreements or other arrangements pursuant to its health care plan as often as it deems necessary for the protection of the interests of the people of this State. An examination must be made not less frequently than once every 3 years. 3. Every health maintenance organization and provider shall submit its books and records relating to the health care plan to an examination made pursuant to subsection 1 or 2 and in every way facilitate the examination. Medical records of natural persons and records of physicians providing service pursuant to a contract to the health maintenance organization are not subject to such examination, although the records are subject to subpoena upon a showing of good cause. For the purpose of examinations, the Commissioner and the State Board of Health may administer oaths to, and examine the officers and agents of the health maintenance organization and the principals of such providers concerning their business. 4. The expenses of examinations pursuant to this section must be assessed against the organization being examined and remitted to the Commissioner or the State Board of Health, whichever is appropriate. 5. In lieu of such examination, the Commissioner may accept the report of an examination made by the insurance commissioner or the state board of health of another state. (Added to NRS by 1973, 1255; A 1991, 2036) NRS 695C.311 Periodic examination by Commissioner to determine financial condition of health maintenance organization. 1. For the purpose of determining its financial condition, fulfillment of its contractual obligations and compliance with law, the Commissioner shall, as often as he deems advisable, examine the affairs, transactions, accounts, records and assets of a health maintenance organization and of any person as to any matter relevant to the financial affairs of the health maintenance organization or to the examination. Except as otherwise provided in this Code, the Commissioner shall examine each health maintenance organization at least once every 3 years. 2. The Commissioner shall examine each health maintenance organization applying for an initial certificate of authority. 3. In lieu of making his own examination, the Commissioner may, in his discretion, accept a full report of the last recent examination of a foreign or alien health maintenance organization, certified to by the supervisory officer of insurance of another state. 4. To the extent that it is practical, the examination of a foreign or alien health maintenance organization must be made in cooperation with the insurance supervisory officers of other states in which the organization transacts business. (Added to NRS by 1991, 2035) NRS 695C.313 Financial examination: Procedure; appointment of examiner; maintenance and use of records; penalty for obstruction or interference. 1. If the Commissioner determines to examine a health maintenance organization pursuant to NRS 695C.311, he shall designate one or more examiners and instruct them as to the scope of the examination. The examiner shall, upon demand, exhibit his official credentials to the health maintenance organization being examined. 2. The Commissioner shall conduct each examination in an expeditious, fair and impartial manner. 3. The Commissioner, or the examiner if he is authorized in writing by the Commissioner, may administer oaths and examine under oath any person concerning any matter relevant to the examination. 4. Every health maintenance organization and its officers, attorneys, employees, agents and representatives shall make available to the Commissioner or his examiners the accounts, records, documents, files, information, assets and matters of the health maintenance organization in his possession or control relating to the subject of the examination and shall facilitate the examination. 5. If the Commissioner or examiner finds any accounts or records to be inadequate or inadequately kept or posted, he shall so notify the health maintenance organization and give the health maintenance organization a reasonable opportunity to reconstruct, rewrite, post or balance the account or record. If the health maintenance organization fails to maintain, complete or correct the records or accounting after the Commissioner or examiner has given the health maintenance organization written notice and a reasonable opportunity to do so, the Commissioner may employ experts to reconstruct, rewrite, post or balance the account or record at the expense of the health maintenance organization being examined. 6. The Commissioner or an examiner shall not remove any record, account, document, file or other property of the health maintenance organization being examined from the office or place of business of the health maintenance organization unless the Commissioner or examiner has the written consent of an officer of the health maintenance organization before the removal or pursuant to an order of court. This provision does not prohibit the Commissioner or examiner from making or removing copies or abstracts of a record, account, document or file. 7. Any person who, without just cause, refuses to be examined under oath or who willfully obstructs or interferes with an examiner in the exercise of his authority is guilty of a misdemeanor. (Added to NRS by 1991, 2035) NRS 695C.315 Financial examination: Payment of expense. 1. The health maintenance organization being examined shall pay the expense of an examination. The expenses to be paid include only the reasonable and proper travel and lodging expenses of the Commissioner and his examiners and assistants, including expert assistance, reasonable compensation to the examiners and assistants and incidental expenses as necessarily incurred in the examination. The Commissioner shall consider the scales and limitations recommended by the National Association of Insurance Commissioners regarding the expense and compensation for an examination. 2. The health maintenance organization shall promptly pay to the Commissioner the expenses of the examination upon presentation by the Commissioner of a reasonably detailed written statement thereof. (Added to NRS by 1991, 2036) NRS 695C.317 Statutory procedures required for examination and hearing. The Commissioner shall use the procedures required by: 1. NRS 679B.230 to 679B.290, inclusive, when conducting an examination of a health maintenance organization. 2. NRS 679B.310 to 679B.370, inclusive, when conducting a hearing involving a health maintenance organization. (Added to NRS by 1991, 2036) NRS 695C.320 Rehabilitation, liquidation or conservation. Any rehabilitation, liquidation or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurance company and shall be conducted under the supervision of the Commissioner pursuant to the law governing the rehabilitation, liquidation, or conservation of insurance companies. (Added to NRS by 1973, 1256) NR

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